5:40 PM, November 5, 2012

Detroit Free Press Medical Writer

Michigan public health officials have boosted to 119 the cases of infection linked to tainted steroid injections for back pain, and a local doctor says some of those patients are now returning for secondary problems from the injections.

Some health officials had believed they were seeing the end of the cases of fungal meningitis and other infections that have led to seven deaths in Michigan and more than two dozen across the U.S.

Of the 119 infections, 61 cases were of fungal meningitis, and six of those patients died. Fifty-one patients have reported epidural abscesses, which can develop into meningitis; and six cases involved joint infections, said Michigan Department of Community Health spokeswoman Angela Minicuci.

A seventh death involved a patient who died after a stroke following the injection, she said.

But other health officials say that — even though they originally believed patients were near the end of the average incubation period from the last injections given in Michigan — secondary infections have them worried that complications will stretch forward for an indefinite period of time.

“If there is a significant fungal load at the site of the infection, the anti-fungal treatments aren’t adequate,” said Dr. Lakshmi Halasyamani, Chief Medical Officer of Ypsilanti-based St. Joseph Mercy hospitals.

The fungus is relatively common in the environment and is normally harmless, but doctors are now learning what happens when it is injected into the spine, she said.

The last injections were given in the beginning of October in Michigan, just before the U.S. Centers for Disease Control & Prevention identified the source of meningitis cases elsewhere and alerted states that had received shipments of the preservative-free methylprednisolone acetate from the New England Compounding Center in Massachusetts.